In part one of this series on sex and fibromyalgia, we dove into investigating and treating low libido. Now let’s discuss oxytocin, a brain chemical that modulates bonding and social behaviors. It is sometimes referred to as the “love hormone” because levels of oxytocin increase during hugging and orgasm. Some researchers have proposed a correlation between the concentration of oxytocin and the intensity of orgasm.

Oxytocin is being explored as a treatment for low libido and sexual dysfunction. In addition to sexual benefits, studies have shownit may benefit depression, anxiety, autism, obsessive compulsive disorder (OCD), and leaky gut!

There is even some evidencethat oxytocin reduces pain by binding to opioid and cannabinoid receptors in the brain and stimulating the brain to release endorphins, and has been suggestedas a treatment for chronic pain.

One study foundthat blood levels of oxytocin were no different in fibromyalgia subjects compared to health controls. However in that same study they found lower amounts of oxytocin for those who reported higher fibromyalgia pain levels.

Daily oxytocin nasal spray (80 IU once a day) did not reduce fibromyalgia pain in one small study, but was found be safe and well tolerated. Typically, when being used for pain management, you would use it three to four times daily, so that might explain the lack of benefit.

More Studies on Oxytocin for Pain· Oxytocin placed in the spinal fluid resulted in dose-dependent reduction of pain in a placebo-controlled evaluationof men and women with acute or chronic low back pain· Intranasal oxytocin reduced headache frequency and pain severity in a sample of individualswith chronic migraine · Oxytocin nasal spray increased pain thresholds in healthy adults for a noxious cold-water stimulus when comparedto placebo

As a brain chemical, oxytocin is associated with empathy, trust, sexual activity, and relationship building. In 2012, researchers reportedthat people in the first stages of romantic attachment had higher levels of oxytocin, compared with non-attached single people. Those couples with higher oxytocin levels at the first assessment were more likely to still be together six months later.

Another studyanalyzed the acute effects of intranasally administered oxytocin on sexual drive, arousal, orgasm, and partner interactions. They found it increased the intensity of orgasm and contentment after sexual intercourse. These effects were more pronounced in men, but female participants also had some benefit and reported feeling more relaxed and able to share sexual desires and connect with their partners. And a case reportdescribed a male who had significant, broad-spectrum improvements in sexual function during a course of intranasal oxytocin treatment for social anxiety.

However, a longer-term studyof the effects on oxytocin or placebo self-administered by women within 50 minutes before sexual intercourse found that both groups reported about equal improvement in sexual function and desire. Since the placebo receivers also reported significant benefit, the researchers theorized that perhaps the real benefit came from the increased focus on sex and increased communication with sexual partners required by participation in the study.

Several of my patients who tried it for libido report that oxytocin makes them “more in the mood for sex.” Just like any treatment, it does not work for everyone, but nobody had any side effects. A few patients who tried taking oxytocin regularly 3–4 times a day did report some pain and anxiety improvement.

Oxytocin can be given intranasally or sublingually, but not orally as it is rapidly destroyed by enzymes in the GI tract. It is usually given as a sublingual immediate release tablet or more commonly as a nasal spray. Oxytocin requires a prescription and it has to be obtained from a compounding pharmacy. For libido, a typical dosage is 24IU intranasal spray 30 minutes before desired sexual activity. Some providers are trying a new approach of topical oxytocin cream for vaginal lubrication for post-menopausal dryness and low libido.

Coming up in part three of this series, we will cover strategies to make intercourse less painful.